Healthcare Provider Details

I. General information

NPI: 1194278879
Provider Name (Legal Business Name): KIMBERLY SPIRES FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2016
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 SIMS ST
ORANGEBURG SC
29115-3434
US

IV. Provider business mailing address

86 WREN ST
BARNWELL SC
29812-1529
US

V. Phone/Fax

Practice location:
  • Phone: 803-813-0399
  • Fax:
Mailing address:
  • Phone: 803-259-5762
  • Fax: 803-259-3250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20284
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: